Therapeutic Revolutions: Medicine, Psychiatry, and American Culture, 1945–1970 by Martin Halliwell (review)

Martin Halliwell’s Therapeutic Revolutions traces the major post-World War II transformations in medicine and psychiatry through the lens of popular culture. To accomplish this ambitious goal, he uses an immense number of sources that include movies, novels, poetry, television shows, popular music, magazine stories, and government and foundation reports, as well as scholarly books, articles, ethnographies, and Ph.D. theses. Halliwell seems to be familiar with virtually all aspects of American culture during this period and provides detailed and knowledgeable examinations of his primary sources.

Halliwell tries to hold together this diverse and omnivorous array of material through a loose theoretical framework grounded in a variant of C. P. Snow’s two cultures model, which contrasts literary and scientific modes of understanding. In Halliwell’s version of this thesis, philosophies propounded by figures such as Carl Rodgers, Abraham Maslow, Herbert Marcuse, R. D. Laing, Erving Goffman, and Thomas Szasz and treatments encompassing various family, group, feminist, Gestalt, and humanistic approaches challenged the emergent medical model advocated by the academic research enterprise, professional organizations, various government agencies, and the pharmaceutical industry. He does not view this dynamic as showing a paradigm shift from one approach to the other; instead, he describes how the two discourses simultaneously combined and clashed. “I have argued throughout this book,” Halliwell summarizes, “that revolutions in medical knowledge and practice bind two opposing trends in a tight knot: the one trend reasserting the authority of medical science and the other positioning medicine as a healing art that upholds the needs and rights of the patient” (290).

The strengths of this book stem from Halliwell’s comprehensive analysis of an astonishing array of diffuse material. Its weaknesses stem from the same source as its strengths. The range of materials the book encompasses is so vast that they are very difficult to integrate into a coherent framework. While Halliwell presents his general view in the introductory and concluding chapters, he rarely uses it to interpret the content of the highly diverse substantive chapters that comprise the bulk of the book. This means that most of the widely ranging material is not synthesized into a coherent narrative. This lack of theoretical integration makes for a difficult reading experience. To take a random example, on one page alone (151) the reader encounters the amateur arts movement in 1950s homes, the novel Revolutionary Road, lay knowledge about healthcare, an episode of I Love Lucy, and scholarly studies about the cost of food. The concluding chapter does mention “seven trajectories” that summarize the major themes of the book, but these seem arbitrary and unrelated to much of what has been presented earlier.

Another problematic aspect of the book is that, while the author attempts to go beyond the two cultures model, many of his central figures do not fit even the more complex framework he develops. For example, one of the era’s central figures, Herbert Marcuse, is difficult to corkscrew into the broadest notion of a humanist philosopher. Likewise, Erving Goffman and Carl Rodgers have little in common apart from the fact that both stood outside the medical mainstream.

While Halliwell’s analyses of the particular phenomena he analyzes are generally on the mark, an exception is his weak grasp of developments in psychiatric diagnosis during this period. He asserts that the DSM-I (1952) provided “rigid definitions of normality” that “served to reinforce rigid medical categories that left little room for a broad spectrum of experience” (170–71). In fact, the definitions found in this manual are extremely vague and general; the opposite of the “rigid” definitions that did not appear until the DSM-III in 1980. He also maintains that depression did not emerge in the manual until 1980, despite the fact that it was one of the psychoneuroses in both the DSM-I and DSM-II (1968). Halliwell also gives short shrift to the...